Proyectos de ley › 88.ª Asamblea General
Dónde está ahora
- Hecho: Presentado5 de marzo de 2019
- Hecho: Subcomité5 de marzo de 2019
- Se detuvo: Comité del SenadoMurió al terminar la Asamblea General
- Sigue: Lo aprueba el Senado
- Sigue: Comité de la Cámara
- Sigue: Lo aprueba la Cámara
- Sigue: A gobernador(a)
- Sigue: Firmado como ley
Murió al terminar la sesión La sesión de 2020 terminó el 14 de junio de 2020, la última sesión ordinaria de la Asamblea General. Los proyectos que no pasaron por ambas cámaras murieron. ¿Qué es el embudo (funnel)?
Qué contiene
La explicación oficial está en inglés; todavía no hay resumen en palabras sencillas.
This bill relates to Medicaid processes, procedures, and oversight. Division I of the bill provides for streamlined processes and oversight under the Medicaid program. The bill requires the department of human services (DHS) to provide for the streamlining of and consistency in Medicaid program processes and procedures relating to prior authorization requirements; utilization of uniform payment authorization criteria and compliance with contract provisions related to timely payment; the posting and updating of a complete and accurate roster of a Medicaid managed care organization’s participating providers; the submission and tracking of claims, claims disputes, claims reconsiderations, and appeals on the Medicaid managed care organization’s website; and the provision of uniform benefits across all Medicaid managed care organizations.
Lea la explicación completa
_____ for proposals process to procure a single credentialing verification organization to be utilized in credentialing and recredentialing providers for the Medicaid managed care and fee-for-service payment and delivery systems. The division requires DHS to contractually require all Medicaid managed care organizations to apply the uniform authorization criteria, to accept verified information from the single credentialing verification organization procured by the state, to approve or deny a provider’s application for credentialing within days of submission for approval, and to contractually prohibit the Medicaid managed care organizations from requiring additional credentialing information from a provider in order to participate in the Medicaid managed care organization’s provider network. Division III of the bill establishes internal and external review processes for Medicaid providers for the review of initial and final adverse determinations of the MCOs’ internal appeal processes. The division provides that a final decision of an external reviewer may be reviewed in a contested case proceeding pursuant to Code chapter 17A, and ultimately is subject to judicial review.
Senate subcommittee
Named March 5, 2019. It hasn’t reported yet.
Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part
Cabildeo
15 a favor · 0 en contra · 6 indecisos · Quiénes →
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